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NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# Aq-- 62a 40 <br /> EHD RECEIVED APP.REFERRAL: �( 03 COMPLETE & SUBMIT BY <br /> DAT DATE <br /> ATTN: i <br /> SITE ADDRESS: I R / <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e.: sewage disposal, <br /> water supplies, etc...). Where necessary, on an attached piece of plain paper, draw completed map of area <br /> showing population density, location of house, wind direction, etc.... <br /> Public water: Public sewage: <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> �Fx***ie 9cx�c is ie*�'e�'c�'c 9e�e 9c de�'e�F***�c*�"e 9c 9e�c a'c icxi�ir ie 9e�e�c�c 9e ie�r ie iezic is icxz*9c�e�c 9c�e�e�F�c�e*xie��e�c�rx**9e�e 9e r'r sx 9c ie�F*�e�c 9e iex*�Fxir ie <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST. Proofread report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE BOOK? <br /> Ii1106 06 Rev V99 <br />